for a minimum of 30 days after DCCV to evaluate thromboembolic (TE) events (stroke, systemic embolism, LAA thrombus) and bleeding events. RESULTS: Overall 474 patients were booked for DCCV, 29.3% received warfarin, 36.5% dabigatran, 21.3% rivaroxaban, 13% Apixaban. Mean age 62.4 AE 13, 70.5% male, 57% had hypertension, 21.3% diabetes mellitus and 26.4% heart failure; 9.7% of the patients had had a previous stroke, systemic embolism, or transient ischemic attack. The higher CHA2DS2VASc Score was seen in warfarin group (3.1 vs 1.7 dabigatran, 2 rivaroxaban, 2.8 apixaban p < 0.01). In the naïve OAC patients the median time receiving OAC prior to cardioversion was higher in warfarin group compared DOACs, 47 (7-62) days vs 30 (21-43) days, p ¼ 0.05. DCCV had to be cancelled or rescheduled in 48 (10%) patients (13.7% warfarin, 7.5% dabigatran, 10% rivaroxaban and 9.8% apixaban p ¼ 0.10). The reason was spontaneous sinus rhythm in dabigatran, rivaroxaban and apixaban. In warfarin 43% had to be rescheduled due to inadequate anticoagulation or presence of left atrial thrombus. TE events occurred in 4 (0.8%) patients: none receiving DOACs compared to 4 (3%) in warfarin group p ¼ 0.02. Major bleeding occurred in 2 (0.4%) patients: 1 on warfarin and 1 on dabigatran group. OAC usage trends varied between 2012-14 as follows: warfarin 42% to 28%, dabigatran 48.5% to 19.8%, rivaroxaban 9.5% to 27.5%, and apixaban 0% to 24.7%. CONCLUSION: DOACs are widely used in patients undergoing DCCV, and in a population with a lower thromboembolic risk. Significant trends in individual OAC usage were also documented with time. Thromboembolic and bleeding events are rare in the first 30 days after cardioversion and are similar among warfarin, dabigatran, rivaroxaban and apixaban.
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